Talk:Mononeuropathy

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Sciatic Mononeuropathy

Sciatic mononeuropathy is a disorder limited to either the right or left sciatic nerve. This disorder is associated with one or more of the following symptoms: Gnawing pain of respective buttock; "pin and needles" in respective leg along the distribution of the sciatic nerve; occasionally, numbness and a sensation of cold foot. The standard neurological examination, EMG and imaging of the spine are all within normal limits. The condition is often confused with degenerative disorders of the spine, especially if the patient also complains of back pain.

The cause of sciatic mononeuropathy is not always clear. Some patients report a fall with hard landing on a buttock. Such a fall occurs after slipping on icy road or wet floor. The intense pounding of the buttock may injure the sciatic nerve. The injury is accompanied by inflammatory reaction and eventually scarring of the nerve. A tight scar might irritate the sciatic nerve in the buttock, leading to the symptoms described above. Similar injury of the sciatic nerve may also occur as a result of repetitive action such as sit ups on thinly padded bench or ridine a bicycle.

Surgical exploration of the buttock may reveal scaring and trapping of the sciatic nerve. There are reports that releasing of the sciatic nerve eliminates the symptoms. However, surgery sometimes fails, perhaps because long term trapping of the nerve causes irreversible damage.

The management of the symptoms of sciatic mononeruropathy is difficult. Gabapentine (Neurontine) in doses as large as 1200 mg four times a day may be needed to decrease the intensity of the pins-and-needles. Some physicians recommend a new drug, Cymbalta, which has been proven effective in diabetic neuropathy.

Insomnia is a major side effect of this disorder, caused by the intense pain in the buttock and the tingling in the leg. A combination of Ambien 10 mg, clonazepam 0.5 mg and gabapentine 1200 mg may be necessary to allow 3-4 hours of sleep. However, this combination of medications may be either excessive for some patients and insufficient for other. It is recommended to start with smalller doses and gradually increase the doses, under the supervision of a physician, until the appropriate dose is reached.

The most qualified physicians to manage this disorder are usually pain specialists - anesthesiosiologists that had also been trained in pain management and are certified as pain specialists by the American Board of Anesthesiology.

[edit] body part falling alseep

I have wondered about the subject. The weird name of the article doesn't help much. Here's some links. I don't know if any are good for the article, but I'm putting them here for reference because some people like to cull links from articles. These are all good sites like science and health ones.

• What makes your arms, legs and feet fall asleep?
• Relates stuff in the above to carpel tunnel syndome and then rambles on, I didn't read all of it
• Why do peoples’ feet “fall asleep?

Anomo 06:20, 1 August 2006 (UTC)